Ease Nausea and Vomiting Associated With Pregnancy

Three out of every four pregnant women will have GI complaints.

Eat small meals or wear acupressure bands (Sea-Band, etc) for nausea and vomiting…elevating the head of the bed for heartburn…or adequate fluid and fibre intake or light exercise for constipation.

If symptoms persist after nondrug steps, it’s okay to try meds.

Nausea and vomiting. Try pyridoxine (vitamin B6) 10 to 25 mg three to four times daily. Move to Rx Diclectin (pyridoxine/doxylamine) if needed…but keep in mind that it can be more expensive.

Add dimenhydrinate 50 mg (Gravol®) every 4 to 6 hours when Diclectin® is not enough. Caution about sedation since it’s common with both doxylamine/pyridoxine and dimenhydrinate.

If you want to try a ginger supplement, try using one with the root and taking 250 mg up to four times daily. Don’t rely on ginger-flavoured foods or beverages…most don’t have enough ginger to make a difference.

Be aware that overall evidence on ginger, pyridoxine, or doxylamine is mixed…but they’re unlikely to harm.

Try saving ondansetron (Zofran®)  for severe symptoms. It’s linked to cardiac malformations in the first trimester…and has QT prolongation risk in the mom, especially with electrolyte changes due to vomiting.

Heartburn. Try antacids first…such as calcium carbonate (Tums Extra Strength, etc) 2 to 3 tabs as needed, but no more than 10 tablets per day.

Consider what is called an H2-blocker if heartburn continues. Ranitidine – an H2 blocker- (brand: Zantac®) has the most safety data in pregnancy.

Reserve PPIs (Proton Pump Inhibitor for the initiate) for persistent symptoms…and stick with omeprazole – a PPI- (brand: Prilosec®/ Losec® in Canada).

Stay away from antacids with sodium bicarb (Alka-Seltzer Gold, etc)…due to risks of fluid retention and alkalosis.

Constipation. Try bulk laxatives (psyllium, etc) first…then adding polyethylene glycol – aka PEG3350- (Lax-A-Day®, Restorolax® etc) or lactulose if needed.

Reserve stimulant laxatives (senna, etc) for persistent symptoms.

Don’t rely on docusate. It’s found in some prenatals and is safe…but there’s not good evidence it helps prevent or treat constipation.

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